Kristie Whitehead, FNP
Individual provider Active NPI Family Nurse Practitioner · Belmont, MS
NPI 1962094680 · NPPES record last updated Feb 4, 2021
Key facts
- NPI
- 1962094680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 904392 (MS)
- Practice address
- 8 Front St
Belmont, MS 38827-7764 - Phone
- (662) 454-1170
- NPI assigned
- Feb 4, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tishomingo Health Services, Inc.
Ms Medical Associates LLC
Practice addresses (Care Compare)
26 3Rd St
Belmont, MS 38827-7737
Phone (662) 454-4520
8 Front St
Belmont, MS 38827-7764
Phone (662) 454-1170
Hospital & facility affiliations
- Tishomingo Health Services Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210408000500 | MS | Practitioner - Nurse Practitioner | 8628485794 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904392 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ms Medical Associates LLC | Current |
Accepting new patients |
Locations
8 Front St
Belmont, MS 38827
Phone (662) 454-1170
Interoperability endpoints
- https://api.platform.athenahealth.com/18642/brand/1/csg/1/fhir/r4
- kristie.whitehead.1@18642.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 904392 | MS | Yes |
Addresses
Primary practice location
8 Front St
Belmont, MS 38827-7764
Mailing address
584 Highway 4
Dennis, MS 38838-9722
Phone (662) 454-8588
Other providers in Belmont, MS
- Tishomingo Health Services, Inc.
- Tishomingo Regional Providers
- Wal-Mart Stores East LP
- Chelsea Wells
- Alexa Sparks White
- Yarber Drug Store Inc
All providers in Belmont, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.